CURABILITY OF VALVULAR DISEASE OF THE HEART IN THE ACUTE STAGE.



Under Belladonna 30, Mercurius sol.30, and Sulph.30, the disease ran a mild course, leaving the boy well, except for the bruit. On May 7th, as there were no symptoms, I put him on Lycopus virginicus 1x, which has a reputation in valvular disease. I could trace no effect to this, nor to Spongia 30, with which I followed it. On 17th of May, taking into consideration that he came of a consumptive family on one side of the house, and guided by the crenated appearance of his teeth, which Dr. Burnett has shown is an indication for the medicine, I gave one dose of Bacillinum 200, and as he had cold, clammy feet, I followed this with Calcarea carb. Under this treatment he made good progress, and on the 10th of June I ceased attending. The bruit was then inaudible when he stood up but could be heard if he lay down.

On December 14th I saw him again for something else, and had the opportunity of examining the heart. He told me he had no shortness of breath on running up stairs, and he could run as well as ever he could. The apex beat was felt in the fifth space, further to the left than normal, and the area of cardiac dullness was greater than normal. On standing no bruit was audible; there was a little accentuation of the first sound at the apex and of the second over the pulmonary artery. On making him lie down I found that the bruit reappeared in all the areas, loudest over the apex, and the action of the heart became irregular.

I have not been able satisfactorily to account to myself for this condition in which there is competence of the valve in the erect, and incompetence in the recumbent position, but it is a condition I have often observed. In one case, that of a child who had at one time unmistakable incompetence of the mitral valve with attacks of violent palpitation and flushing of eyes and face following whooping-cough, I found, after some years, that the bruit could only be heard when she lay down; and still later it could not be heard at all. There was no anaemia in this case. Some defect of the posterior flap of the valve, or irregular action of the columnae cardiae may possibly account for it.

I will now relate another case of very extensive heart inflammation which resulted in a practical cure.

CASE VI.-ACUTE INFLAMMATION OF THE PERICARDIUM AND VALVES OF THE HEART. PROMPT ACTION OF Spigelia. RECOVERY.

On the 22nd June, 1889, James T., a chimney-sweep, aged 44, came to my hospital clinic on the recommendation of a private patient of mine who had persuaded him to try Homoeopathy. When he entered my out-patients’ room it was easy to see he was exceedingly ill.

Like most of his class he had led a hard, reckless life. He commenced chimney-sweeping as a tiny boy in the days when boys were sent up the flues instead of the machine brushes now used. Naturally he was a man of powerful physique; but now it had been with the greatest difficulty that he had succeeded in reaching the hospital. He had the blurred, heavy look of countenance-a sort of indistinctness of features-sometimes noticed in sufferers from heart disease. He felt just as ill as he looked, for he afterwards told me that he never expected to reach home again alive.

Fourteen days before, he had taken cold from getting wet during a trip to Oxford on the river. This was followed by a cough with raising of thick phlegm, the cough being so painful that he had to hold himself, and this had continued. The chief thing he now complained of was a pain at the heart as if it were swelling up. The pain gradually moved down, and the night before his visit to me was in the left flank; then it moved up to the heart again. Sensation as if a big knife went through it, aggravated on taking a breath. The pain prevented him from sleeping; it was impossible for him to lie on the left side. Tongue white; appetite good, but he could not eat, because eating brought on the pain. Bowels confined; he had a choking sensation in the epigastrium, and a dizziness in the eyes.

On examining the heart I found there was an increase in size, a pericardial rub, and bruits in the aortic and mitral areas; that is to say, there was pericarditis with effusion and endocarditis as well.

The knife-like pain in the heart singled out Spigelia from all the other medicines related to his condition, so I gave it him in the third centesimal dilution, a dose every hour.

He slept well that night, as he was able to breathe better. The next day I called at his house, and I found a decrease in the pericardial rubbing sound, and a diminution in the area of cardiac dullness.

June 24th.-Still better; sleeps well; has no pain; appetite good. On this day I made the following notes of the state of the heart:- Slight rub heard over centre of heart.

Mitral area: double bruit, the systolic portion being heard in the axilla.

Tricuspid area (right border of sternum on level of fourth rib) : a double rough grating sound.

Aortic area : a double bruit.

On the night of the 25th-26th (as his wife informed me) his breathing seemed to be arrested; it began again with a gasp.

The Spigelia 3 was continued all this time, though it was not given so frequently as at first. From the 25th it was given every two hours.

A few weeks after this he mentioned a circumstance which occurred during the time he was taking Spigelia-the loss of a pain in the right knee which had troubled him for eighteen months. If he knelt on it he was unable to get up without going down on the other knee as well, and then stretching out the right leg. The pain was as if the knee got out of joint. He had been sometimes for hours at night before he could get it into the right position in bed. He asked me if my medicine could have had anything to do with its disappearance; for as he had not told me anything about it before, he did not see how I could have cured it. On referring to Allen, I found this in italics: Tearing pain, like a sprain, in the left knee, only when walking, so that at times he limped, since he could not bend the knee as usual. Other similar symptoms refer to the right knee and both knees. That the Spigelia must have the credit of this bye-cure I proved later on, for the pain in the knee returned; but a few doses of the Spigelia 1m F.C. permanently removed it.

But to go back. By July 1st he was quite free from any chest symptoms: he could lie on either side. But he was weak in the calves, had giddiness, and suffered from constipation with straining. Nux 1m relieved the latter condition.

On July 3rd he was still complaining of weakness in the legs, so I put him on Baryta. c. 1m, after which there was rapid improvement.

He continued on this medicine, with a rest, till August 10th. Occasionally he had palpitation on lying down at night; on the 5th there was slight pain in lower part of left chest; on the 12th numbness of left shoulder and arm. On August 1st he had an attack of giddiness in the evening whilst walking in the street. He resumed work on the 9th of August. On October 11th he declared he felt as well as ever he did in his life. Being an enthusiastic member of the Volunteer force, he had been testing his powers by practising ball-firing. The following Easter he went through the fatigues and exposure of the Easter Volunteer manoeuvres, indulging himself even (without asking my permission, I need hardly say) in bathing in the cold spring sea.

On the 19th of March, 1893, I called upon him to make an examination of his present condition. For the last eighteen months he has been better, he says, than for years before. His pulse was 72, regular, steady and of good force. I append his sphygmogram, taken from the left radial, standing, with a pressure of 3 1/2 ounces. It does not differ from a normal tracing except, perhaps, in the strength and sharpness of the upstroke and sudden though quickly arrested return.

Examination.-The area of dullness is still greater than normal; the apex beat is felt in the sixth interspace and more to the left than normal. Coming to the heart sounds, I find, of course, no pericardial rub. Also the mitral bruit and the grating sound (probably pericardial) in the tricuspid area are no longer to be heard. The double aortic bruit still remains. In the tricuspid area the first sound is clear, and a soft bruit replaces the second. This is probably the aortic diastolic propagated downwards. In the mitral area the first sound is somewhat impure-not the clear, sharp click of a normal valve-but there is no bruit, showing that the valve is competent.

In this case I conclude that under the treatment-that is, under the action of Spigelia and Baryta carb. chiefly-the inflammation of the heart, which affected both the outer and inner lining, was subdued, and the affection of the mitral valve was so far remedied that it has been restored to competence. The aortic valves remained still as they were, but the softness of the systolic portion of the double bruit shows that the degree of obstruction to the blood-flow is but slight, and the softness of the diastolic part that the regurgitation is not considerable. This shows that there has been, at any rate, an arrest of the disease process, and I am disposed to think that the aortic trouble dates from before the time when I first saw him.

John Henry Clarke
John Henry Clarke MD (1853 – November 24, 1931 was a prominent English classical homeopath. Dr. Clarke was a busy practitioner. As a physician he not only had his own clinic in Piccadilly, London, but he also was a consultant at the London Homeopathic Hospital and researched into new remedies — nosodes. For many years, he was the editor of The Homeopathic World. He wrote many books, his best known were Dictionary of Practical Materia Medica and Repertory of Materia Medica